Home health rule imperils elderly, disabled

Home health rule imperils elderly, disabled

Millions of elderly and disabled Americans rely on the help they get from home health care workers. That aid lets a lot of people avoid going into nursing homes.

In an ideal world, all of the elderly and disabled would have plenty of money to offer generous pay to the people -- sometimes full-time workers and sometimes more or less companions -- who provide that care.

But in the real world, many of the elderly and disabled are on very limited fixed incomes. They do not have the ability to pay ordinary minimum wages and overtime to those who help them with tasks they must perform in order to be able to remain in their own homes.

And so, since 1974, the federal government has permitted them to make other payment arrangements with home health care workers, even if that does not equate to full minimum wages and overtime. For example, a person who stays most of the time with a disabled elderly person may simply get a flat hourly rate, even if the work exceeds 40 hours per week. Most states also exempt such workers from wage laws.

Is that system perfect? No. Would we like it if there were a giant pot of money to give the workers higher regular pay plus overtime? Certainly! But that's just not reality.

And what we clearly can't do -- without serious negative effects -- is overturn the long-standing exemption of home health care workers from wage laws.

Unfortunately, that is what President Barack Obama is proposing. He says those who receive home health care will soon have to start paying at least minimum wage -- plus overtime.

That could in many instances double or even triple what recipients of care must pay. Many will have to try to do without home assistance, and others may be forced into nursing homes as a result. And that is only going to get worse as our population ages and millions more people need assistance at home.

Such are the painful unintended consequences of government wage-setting.